Department of Orthopaedic Surgery, Centro Traumatologico Ortopedico (CTO), University of Turin, Via Gianfranco Zuretti, 29, 10126, Turin, Italy.
Department of Orthopaedics and Traumatology, CTO, University of Turin, Via Zuretti 29, 10126, Turin, Italy.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4027-4036. doi: 10.1007/s00590-024-04103-5. Epub 2024 Sep 20.
Dislocations of the elbow are the second most frequent upper-body injury after shoulder dislocations, comprising 11-28% of all elbow injuries. Complex elbow dislocations pose challenging management due to the involvement of critical stabilizing structures. This study aimed to investigate functional and subjective outcomes (MEPS, DASH, Oxford score) in 44 patients with complex elbow dislocations who underwent surgery between 2018 and 2020, with subgroup analysis focusing on gender and age differences.
A retrospective analysis was conducted on patients treated at C.T.O. Hospital, Turin, for complex elbow dislocations between January 2018 and December 2020. Surgical approaches included radial head synthesis, coronoid fixation, ligamentous repair, and ulnar nerve management. Postoperatively, patients followed a standardized or individualized program. Data analysis involved t-tests to assess score differences between subgroups.
Among the 44 analyzed patients, the mean age was 48 years, and the mean follow-up time was 29 months. Various types of complex dislocations were identified, with radial head and coronoid fractures classified accordingly. Surgical approaches included multiple methods of reduction and synthesis. While most patients adhered to postoperative programs, subsequent reoperations were conducted in 11% of cases. Scores did not significantly differ between genders, although a trend toward better DASH scores in males was observed. Younger patients showed better, though not statistically significant, outcomes in mobility and functional measures.
This study underscores the importance of pre-operative assessment for positive surgical outcomes in complex elbow dislocations. Additionally, findings suggest that younger age may correlate with slightly better functional outcomes. Despite limitations such as retrospective design and sample size, the study enhances our understanding of complex dislocation outcomes and provides valuable insights for future interventions.
肘部脱位是继肩部脱位后第二常见的上半身损伤，占所有肘部损伤的 11-28%。复杂的肘部脱位由于涉及关键稳定结构，因此在管理方面具有挑战性。本研究旨在调查 2018 年至 2020 年间在 C.T.O. 医院接受手术治疗的 44 例复杂肘部脱位患者的功能和主观结果（MEPS、DASH、牛津评分），并进行亚组分析，重点关注性别和年龄差异。
对 2018 年 1 月至 2020 年 12 月在都灵 C.T.O. 医院接受治疗的复杂肘部脱位患者进行回顾性分析。手术方法包括桡骨头合成、冠突固定、韧带修复和尺神经处理。术后，患者遵循标准化或个体化方案。使用 t 检验评估亚组之间的评分差异进行数据分析。
在分析的 44 例患者中，平均年龄为 48 岁，平均随访时间为 29 个月。确定了各种类型的复杂脱位，桡骨头和冠突骨折也相应分类。手术方法包括多种复位和合成方法。虽然大多数患者都遵守了术后方案，但仍有 11%的患者需要进行后续手术。虽然男性的 DASH 评分略好，但性别之间的评分没有显著差异。年轻患者在移动性和功能测量方面的结果更好，但无统计学意义。
本研究强调了术前评估对复杂肘部脱位手术结果的重要性。此外，研究结果表明，年龄越小，功能结果可能略好。尽管存在回顾性设计和样本量的限制，但该研究增强了我们对复杂脱位结果的理解，并为未来干预措施提供了有价值的见解。
